Dr Mark John Nizibian, DDS in Petaluma, CA - Medicare Dentist Provider

Dr Mark John Nizibian, DDS is a medicare enrolled "Dentist" provider in Petaluma, California. His current practice location is 1122 B St, Petaluma, California. You can reach out to his office (for appointments etc.) via phone at (707) 763-1688.

Dr Mark John Nizibian is licensed to practice in California (license number DA 034394) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1023386638.

Contact Information

	Dr Mark John Nizibian, DDS
	1122 B St, Petaluma, CA 94952-4055
	(707) 763-1688
	(707) 763-5152

Healthcare Provider's Profile

Full Name	Dr Mark John Nizibian
Gender	Male
Speciality	Dentist
Location	1122 B St, Petaluma, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023386638
Provider Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011

Medicare PECOS Information:

PECOS PAC ID: 6608175526
Enrollment ID: I20160427002343

Medical Identifiers

Medical identifiers for Dr Mark John Nizibian such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023386638	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DA 034394 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark John Nizibian is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mark John Nizibian, DDS 1122 B St, Petaluma, CA 94952-4055 Ph: (707) 763-1688	Dr Mark John Nizibian, DDS 1122 B St, Petaluma, CA 94952-4055 Ph: (707) 763-1688

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Dentist in Petaluma, CA

Dr. Michael David Zatto, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1400 Professional Dr, Suite 101, Petaluma, CA 94954 Phone: 707-765-9630 Fax: 707-765-9630
Dr. Thomas Vincent Dembski, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1430 E Washington St, Petaluma, CA 94954 Phone: 707-762-0067 Fax: 707-762-4782
Dr. Thomas Randall Szutz, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 401 Kenilworth Dr, Suite 960, Petaluma, CA 94952 Phone: 707-789-9600 Fax: 707-789-9549
Dr. Stephen H Nagle, Dentist Medicare: Not Enrolled in Medicare Practice Location: 511 Hayes Ln, Petaluma, CA 94952 Phone: 707-763-2654 Fax: 707-763-3141
Dr. Martin Richard Steigner, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3835 Cypress Dr, Suite 210, Petaluma, CA 94954 Phone: 707-763-1548 Fax: 707-763-6942
Dr. Mark Roper, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3835 Cypress Dr, Suite 203, Petaluma, CA 94954 Phone: 707-766-7668 Fax: 415-382-1520

Dr Mark John Nizibian, DDS - Medicare Dentist in Petaluma, CA